Summary

This poem, written in five sections of free verse, begins with the speaker remembering the old steel bridge he used to drive over on his way to work. He describes how the gaps between the steel beams had given him access to the world beyond the bridge: he had been able to see the river bank and railroad tracks and, most importantly, the people down there, "wild dangerous men" living near the edge of the river.

The poet next describes the new bridge, with its smooth speedy surface and solid concrete sides concealing the view. He then steps back and reflects: "what now?" He compares the engineer making the bridge with his own writing, "diminish[ing] the homeless to a poetic abstraction," and asks where this leaves him. Both bridge and abstraction, he implies, take the life, untidy and dangerous but valuable, out of his experience of crossing the Missouri.

He cannot view the material for his poetry now, unless he were to stop, back up the traffic, and risk his life climbing the walls of the bridge, and even then he does not know what he would say, because the new bridge has made him realize something about himself: "I am partly the leech come to feed, / yet I cannot waver from my groove." As a poet, he needs access to the lives of others, an access he likens to parasitism. But his career, the work to which he is going, requires him to speed on across the bridge without pausing.

He now elaborates on his distance from the world of the homeless people (and, by implication, all the other material for his poetry), saying that he has "safely bled away the guilt, / and pity and compassion," from his involvement or complicity in the meaning of his material, and "channeled it" into the poem. The leech image is now applied to the poem which, once filled with those ambivalent emotions, becomes separate from the poet and attaches itself instead to the reader, who now becomes the one feeding on the "dark spurt of old blood," the horrifying riches of which the speaker has rid himself.

Commentary

That this poem has anything to do with medicine is perhaps not immediately evident, until one observes that the poet is a physician and that the image of the "leech" works on more than one level; as well as describing a helminth, it is the old and usually pejorative nickname for a doctor, because of the use of leeches in therapeutic blood-drawing. Calling himself a "leech," then, not only marks the poet as one who feeds off what he observes in order to produce his poems, but also indicates his profession, the work to which he is driving, the "groove" from which he "cannot waver."

As a poet he envisages himself gorging on the lives of patients, but as doctor he must make efficient progress, having bled (leeched?) the emotion and ambivalence out of himself. In the grotesque final image, he resolves his dilemma: the poems, filled with the blood/emotion he has drawn from his material, go on to feed his readers in a kind of poetic-parasitic food chain that coexists with the rather sterile but necessary efficiency of the new bridge and all it stands for. To this extent, the poem captures beautifully the dichotomy and achievement of the physician poet, and of medicine itself: the image of the leech holds together scientific detachment (the bridge) and empathetic human involvement (the bloody, untidy, and nourishing world beyond it).